Chasing infinity: Why clinical psychoanalysis' future lies in pluralism

Cardiac Self‐Disclosure: Clinical and Theoretical Reflections

“…Wallerstein's (2002) phrase, 'common ground' (p. 5), captures the idea. As noted in prior publications (Karbelnig, 2018b(Karbelnig, , 2018c(Karbelnig, , 2022, psychotherapists' work features a unique, consistent architecture. They frame the psychoanalytic interpersonal relationship to maintain professional boundaries and create an environment within which psychoanalytic processes develop.…”

“…Additionally, the medical situation allowed me to expand upon the endlessly fascinating paradox between depth of psychotherapists’ ‘common ground’ (Wallerstein, 2002, p. 1251) and participants’ individualities in psychoanalytic processes. As noted in a recent publication (Karbelnig, 2022), I promote clinical pluralism. Irreconcilable theoretical differences linger, for example, the Kleinian emphasis on innate aggression versus Fairbairn's view of aggression as reactive, or the classical psychoanalysts’ minimal self‐disclosure versus the relational practitioners’ liberal sharing of subjective experiences.…”

“…Subjectivity emerges from complex, interactive biological, economic, sociological, cultural and historical processes. Metapsychology tries to create bounded models out of boundlessness phenomena (Karbelnig, 2022).…”

“…Several patients reacted in surprising ways. Three clinical examples vividly illustrate the above-noted themes, particularly the uniqueness of each dyad, the need for improvisation, and the application of a cross-theoretical model (Karbelnig, 2022).…”

“…Fourth, the urgency of my specific medical situation invites exploration of the dialectical tension between the stasis and dynamism of oft‐wildly divergent psychoanalytic models (Karbelnig, 2022). Certain fixed views I held towards patients, that is, degree of self‐valuation, level of dependency needs, or transference–countertransference configurations, were contradicted by their reactions to the disclosure.…”